Interview with Dr. Yinghong Wang on her book – Managing Immunotherapy Related Organ Toxicities: A Practical Guide.

Transcript:

Dr. Deng: “Hi everyone! Welcome to the Cancer News Book Interview today. I am Dr. Lei Deng, the thoracic and head and neck medical oncologist at the University of Washington and Fred Hutch. Today, we are very fortunate to have Dr. Yinghong Wang from MD Anderson to join us. Welcome Dr. Wang.”

Dr. Wang: “Thank you. Thank you for the invitation.” 

Dr. Deng: “Dr. Yinghong Wang is a gastroenterologist and the chair of MD Anderson Institution of Immunotherapy and Toxicity Working Group, Director of Inflammatory Bowel Disorders, and Director of Fecal Micro Biotransplants. Really an excerpt in managing immunotherapy related to toxicity in GI aspects. She leads the work of building management algorithm of immunotherapy, induclyotis at MD Anderson, and the served ask panel of immunotherapy inducylotis at ASCO, CT, CCN, ESMO, AGN, and up to date. So, I met Dr. Wang last month at the 2023 Cancer Immunotherapy Summit by the Binaytara Foundation, where I found her book Managing Immunotherapy Related to Organ Toxicities – A Practical Guide. I think this is a really great book and I want to introduce this book to more audiences. Dr. Wang, can you tell us about this book briefly? And what prompted you to write this book?“

Dr. Wang: “Yes, absolutely. This is a great opportunity for me to share, you know, what our thinking process and how we made it happen. So, this is the first book focusing on immunotherapy toxicity alone with a very comprehensive review from a thoracic cancer center encompassing 15 topics reflecting the management of complex and challenging toxicity cases. It will serve as a very useful resource for the oncology community to manage toxicities and have gained recognition. So, why I think, you know, the main reason that we are doing it is different from the existing books in the market is that I previously contributed to a few handbooks focusing on immunotherapy with a few chapters focusing on toxicity as a minor portion of the book. So, I realized there is never a toxicity-focused handbook that’s ever been published which is a critical need in the current clinical practice. Actually toxicity management has become such a big hurdle in the current era leading to disruptions of cancer treatment and negative impact on the cancer outcome. Therefore I decided to take this task and accomplish it with collaboration of 15 amazing toxicity specialists from MD Anderson.” 

Dr. Deng: “That’s really amazing. Yeah, as medical oncologists, we do see a lot of patients getting immunotherapy relating to toxicity. Although we are having this internal medicine background, we have to really understand the specificity of the organ-specific questions which is really challenging. and this research is very helpful.  So, Dr. Wang, we have seen some guidelines from ASCO, CT, CCN about immunotherapy related to toxicity. So how is your book different from this?”

Dr. Wang: “Yeah, definitely. That’s a great question. I would say in the clinical practice on the daily basis, you, me, and everyone else in the clinical field. So frequently we would encounter these kind of dilemmas in our diagnosis and treatment and especially in refractive cases and the standard of treatment. Therefore, the reference in this field is very useful and critical to facilitate this kind of care. Even though there are many guidelines available and societies that I have been honored to contribute to. But, I think it’s still a big struggle to search up online to find the right guideline that is readily available on PubMed or Institutional library website where we get these guidelines and there are 50 pages of that. It’s a easy handbook to have in your pocket for this kind of particular book that I think is going to a better resource to use in that circumstance, it’s readily available, and everything is there.” 

Dr. Deng: “Yeah, that’s great. Because I feel like sometimes the guidelines are not in detail. Sometimes I look at the guidelines and there are some words but I really don’t know how to put that for my patients into perspective.  There is more detail in the book and it’s in a handbook format so that should be very helpful and handy. So, what is your favorite part of this book?” 

Dr. Wang: “So, in this particular book we included a feature that I feel very good about. So there is a video for every chapter helping review that is associated with the electronic version. The paperbook doesn’t have that capacity but you know the reader, their interest, they can get exposure of the audio/video. So they can get a lecture series, you know, on all the 15 topics which I think is a big plus point. I don’t think that’s usually included in other options in the market. “

Dr. Deng: “Oh, that’s wonderful. That’s very good resources. That’s really a bonus point to access the online version.”

Dr. Wang: “Yes, absolutely.”

Dr. Deng: “So, if there is only one device for doctors and healthcare providers taking care of cancer patients who use immunotherapy. What would you see from the toxicity standpoint?“

Dr. Wang: “Right, so the first thing I want to emphasize is don’t give up on immunotherapy due to toxicities. I know that cardiologists and radiologists are going to disagree with me and say no you can’t make that kind of statement as they could relapse. I totally agree with that. But, luckily for GI, I think I’m in the comfort zone where I can manage with a good outcome. So I think it’s time for a better cancer response. So I think early in the disease course immunotherapy can always be on your list of consideration at any stage of cancer treatment for oncologists. So, that’s how I want to make the statement as the advantage of being a gastroenterologist.”

Dr. Deng: “Yeah, I think this field is really evolving. Initially, when we were doing immunotherapy trials we were excluding all patients with multi immune disease and we stopped the medication once we have immunotherapy. More and more data is showing toxicities can be managed and if you have the appropriate resources. So, I definitely agree with you on that. So what will come next in managing immunotherapy related to toxicities in your perspective?“

Dr. Wang: “Yeah, so there are a lot of clinical challenges that still exist in toxicity management especially when we should restart immunotherapy and at what point should we permanently stop the immunotherapy. So I think there are a lot of critical needs for us to fill in the knowledge gap. I’m very excited to see this field is evolving and growing and a lot of interest from a lot of academic centers worldwide who apply their effort together. I’m pretty sure in the next five years maybe we will not need this discussion anymore and everything is straightforward and standardized. But, regardless, with all the resources and educational activities that we can use to make it easier for all the clinical providers. Other than that, we are working on our 2nd immunotherapy toxicity book and this time we are focusing on the toxicity-challenging cases. This is going to be across ten academic centers globally and we are hoping to get that published in the year of 2024.” 

Dr. Deng: “Wow, that’s excellent. I look forward to the new book. So I see that you are in charge of supervising the IOTX Clinical Symposium held in Houston. Can you tell me more about this symposium?“

Dr. Wang: “Yes, absolutely. Thank you for giving us the opportunity to talk about this. So we organized the last symposium last year in December, it was very well received, and we received 200 attendees worldwide because of the hybrid form. So this year we try to expand it even further and we are organizing the second international symposium clinical symposium on December 2nd.  Hybrid and will cover more than 12 toxicity reviews as the challenging case discussion for the internal MD Anderson and external panelists.  Our event will welcome all the pharmaceutical companies, clinical providers, physicians, fellows, residents, and nurses to join us in sharing your experiences in managing toxicities and maybe bring up the challenging cases that you have. So we have some specialists that can share their experiences and input and hopefully we can learn from each other. And register to attend, otherwise it’s online. You can simply search MD Anderson IO Toxicity Clinical Symposium.” 

Dr. Deng: “Thank you so much. That’s really great. I really recommend everyone to attend this. So, thank you Dr. Wang for your time to introduce your book and the symposium. I highly recommend everyone to read the book Managing Immunotherapy Related Organ Toxicities: A Practical Guide. It’s available on Amazon and Kindle as well. We will include links on our webpage for your future reference. Thank you.”